Swim Sci

Swim Sci

Wednesday

Spinal biomechanics and swimming Part I: Cervical Spine

Spinal biomechanics, aren't they the darnedest!

As I review my mentoring notes, I commonly cross bits of information which I happily translate into swimming biomechanics. In preparation for my spinal biomechanics, prevention, and rehabilitation lecture I encountered a few interesting notes. Now it is important to keep in mind, a lot of the research on spinal mechanics is performed on porcine models. If the research wasn't on porcine models, it was likely performed on corpses. Luckily, newer research on spinal biomechanics is actually analyzing actual humans (if you're interested in staying up on the research, consider buying the Swimming Science Research Review).

As I was analyzing my notes, I started at the cervical spine and began thinking about freestyle breathing. The freestyle breath is the most commonly used breath in the sport, but many swimmers perform it improperly. In fact, many people are classified as "armpit breathers", a non-scientific term for swimmers who appear to be smelling their armpit as they breathe. Many feel this is simply due to improper breath timing, which can undoubtedly cause armpit breathing, but I think spinal biomechanics also play a role in those process.

The cervical spine has three main planes of motion: saggital, frontal, and axial (for more informational on planes, check out the Start Here section). Freestyle breathing should be a uniplanar movement in the axial plane (rotation). However, many swimmers perform rotation and side bending (in the frontal plane) as one movement. This is likely due to the configuration of the cervical spine, specifically the facet joints. The facet joints help control motion, but also contribute to motion as their congruency encourages movements in specific motions. As the neck rotates, the facet joints slide backwards resulting in a coupling motion of side bend. 



These biomechanics suggest it is more favorable to side bend your head during rotation, than to simply rotate your head! So, freestyle breathing may actually require actions opposite of normal function! Swimming is a tough sport already, now it requires moving against the body!

By G. John Mullen founder of the Center of Optimal Restoration, head strength coach at Santa Clara Swim Club, creator of the Swimmer's Shoulder System, and chief editor of the Swimming Science Research Review.

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Tuesday

Force Potential of the Early Vertical Forearm Part II

Last week the Force Potential of the Early Vertical Forearm was discussed . Unfortunately, knowing the definition does not necessarily cause improvement. Knowing is only half the battle!

Being able to adapt to and reduce potential flaws is essential for elite performance. Too often attention is given to the wrong area. For example, many coaches instruct the early vertical forearm, but the inhibitors may exist outside of the water that make these cues useless. It’s like yelling at a turtle to get up on its hind legs and dance- not physically possible!If something cannot be performed on land, then it is unlikely to occur in the water. This is not to say that performing the early vertical forearm repeatedly on land is a good idea, as this needlessly increases the risk of injury.  However,  screening to identify limitations is a mandatory step if coaches want their “EVF” cues to further their swimmers performance (rather than frustrate everyone involved.)

Deficiencies in muscle length, muscle strength, and muscle timing often prevent ideal movement. If a muscle is overactive, range of motion for the joint will be impaired. If it is weak, the body is unable to perform the movement properly. If it doesn’t have the muscle timing, then co-activation and aberrant movement exist, exacerbating and potentially inducing the aforementioned conditions. Much more about this can be found in the Swimmers Shoulder System or Troubleshooting publication with Allan Phillips (planned release date December 2012).

Another common mistake is to only consider the shoulder complex when addressing deficiencies. I believe that the shoulder is the first area to consider, as many of the answers are found in this joint. However, a joint by joint approach is necessary for maximum benefits. This typically means improving the joints proximal (cervical spine) and distal (thoracic spine) to the glenohumeral joint but could potentially be further away (hip or ankle). This makes it imperative to check for muscle length, strength, and timing at these joints as well.

The first step to assessing whether an athlete get achieve an EVF is determining whether the athlete has the necessary range of motion outside of the pool. If they do not, it is likely they have tight muscles (such as, potentially the infraspinatus) inhibiting this motion. However, assessing the muscle strength of the rotator cuff and scapular stabilizer muscles is key. Lastly, seeing if the athlete has control at the end range of internal and external rotation is key, as proper motor control or timing is essential for an proper early vertical forearm.

Next, check the neck range of motion, strength, and timing between the neck and the shoulder. If an athletes has any limitations at the neck, they could have impairments at the shoulder as many of the cervical muscles attach to the shoulder blades and collar bone.



The thoracic spine is a potential structure that limits EVF capability If the athlete has poor thoracic extension range, they it is likely their rotator cuff muscles have inadequate room for movement, potentially resulting in impingement. Also, if the thoracic spine and shoulder muscles do not work together, then as the shoulder flexes the thoracic spine may not respond with the necessary extension. Moreover, if the athlete performs flexion and internal rotation (EVF) the spine must slightly extend, allowing adequate rotator cuff and shoulder blade movement.

 

Think she has a good EVF?
As stated, the shoulder, neck, and thoracic spine are not the only areas for consideration. However, starting by investigating these areas often provides the most benefit. Make sure you are screening not only in the water, but also out of the water. This can be performed with the Swimmer Movement Screen.  Swim Sci now offer online movement screens via Skype, through which our expert team can help you and your swimmers to identify their structural limitations.
Only $50/screen

By G. John Mullen founder of the Center of Optimal Restoration, head strength coach at Santa Clara Swim Club, creator of the Swimmer's Shoulder System, and chief editor of the Swimming Science Research Review.

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Wednesday

Stay High Chariot

Butterfly breathing and body position are like two peas in a pod. If you have improper breathing your body position will suffer dramatically.  This is why many flyers become vertical as their velocity decreases.   

Some elite butterfly swimmers are able to breathe more frequently, but this is due to their ability to keep their hips high and dissociate their head, hips and thoracic spine.  For example, many vertical flyers lift their chest since they are unable to lift their head without the chain reaction of hip lowering occurring simulataneously. Imagine a seesaw, as one side goes up, the other end will lower, this analogy can be used for the vertical flyer. As their head rises, their hips lower and increase drag. This can be due to range of motion deficits in the thoracic spine, impaired strength in the cervical or lumbar spine to not be influenced by the rest of the body.

Many swimmers have difficulties keeping their hips high, while extending their thoracic spine, pressing their chest down and forward while extending their neck. Opposing, when a swimmer does not breathe their hips need to remain hip with the thoracic spine extended with their neck held in neutral.  Improving thoracic spine motion is mandatory to improve this motion. Next time at practice have your elite flyers lean back with their arms overhead. See if they have more range of motion than your poor flyers. Most elite flyers will have more range of motion, therefore why not include mobility exercises to improve this range of motion? What exercises do you use to improve this range and what stability exercises do you use control this new range of motion?
By Dr. G. John Mullen, DPT, CSCS. He is the founder of the Center of Optimal Restoration and head strength coach at Santa Clara Swim Club.

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Air Suckers


Many age group swimmers have breathing abnormalities during freestyle.  Two common flaws are lifting their head and breathing late. This can lead to increased anterior shoulder stress, higher drag and instability of the lower body.
  • Shoulder Stress: If an athlete breathes late/lifts their chest, anterior shoulder stress will increase as the athlete likely positions their arms laterally during initial catch to balance their body. If the athlete lifts their chest during the breath, the distance from their head and shoulder is increased, once again stressing anterior shoulder structures.
  • Increased Drag: When a swimmer breathes late, their lead arm is commonly not above their head, which is less hydrodynamic than breathing with their arm above their head (in a half streamline).  A breath should occur when the body is in the most streamline position, minimally disrupting the streamlined freestyle. If the athlete lifts their chest during a breath, their chest will act as a wall, increasing drag during swimming. Coaches often refer this as plowing through the water.
  • Lower Body Instability: When a swimmer breathes late, the head movement will cause a ripple effect down the legs, potentially causing hula hooping hips. Unless the swimmer has excellent frontal and transverse plane strength (which some do, allowing them to get away with this flaw), their hips will cause extra drag and a less streamlined position.


A simple, yet effective method to improve this deviation is cuing the athlete to push their chest down during the breath.  This can practiced with various drills with the swimmer using a kick board under their chest.  This forces them to keep their chest down the whole time in their stroke.

Another reason for this abnormality is impaired cervical rotation or cervical stability, therefore means to check these movements are necessary to ensure proper dynamic structures are mandatory.

GJohn

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Friday

Trouble Shooting Series: Lumbar Spine

Part three of the trouble shooting series by Allan Phillips see part 1, Troubleshooting Series: Cervical Spine and part II, Trouble Shooting Series: Thoracic Spine.

Perhaps no area of the body has been more controversial in both the medical and strength and conditioning worlds than the lumbar spine, or more generally, the low back.  Much like the neck, the low back offers equal opportunity affliction, with painful implications for both elite athletes and sedentary folks. Many swimmers bring non-swimming related back pathologies to the pool.  While coaches can't treat these conditions, they can affect both performance and health with informed programming choices

For swimmers, lumbar spinal health and performance is foremost a matter of timing and control.  Most swimmers have adequate strength in absolute terms.  The absolute strength demands of swimming in a nearly zero-gravity environment are quite modest.   What swimmers often lack are the mechanisms to allow the expression of that strength in the pool.  The lumbar spine literally has no place to hide when the thoracic spine, hips, and pelvis don't do their jobs.   We must never neglect the timing of the core musculature in coordination with adjacent body segments.

The lumbar spine is designed for approximately 10-12 degrees of safe rotation.  In contrast, some individual T-spine joints have that much alone.  Not only is the lumbar spine at risk for damage if we exceed this range, adding range of motion to the low back without a corresponding level of control will come at the expense of hip and T-spine mobility.

Potholes -
-Lower cross posture - Tight/overactive low back muscles and hip flexors in conjunction with weak/inhibited abdominals and glutes.  Swimmers who live with this posture both in the water and on land aren’t able to access the full capabilities of their low back muscles.  In the water, this condition most commonly manifests itself in freestyle: Freestyle flaw: back archers, butterfly flaw: sway back.  
-Limited pelvic control – A limited range of motion not and/or chronic anterior tilt (common with Master’s swimmers)  not only affects the undulation of the short axis strokes and underwater dolphin kicking, it will also impede hip rotation (possibly leading to hula hopping).  Swimmers who aren’t afflicted with a postural limitation may still lack the pelvic tilting skill. If  the swimmer doesn’t have major underlying restrictions, most will pick up the skill quickly once taught.     

-Left to right imbalance - A swimmer who brings unevenness to the pool invites hula hooping, or at best, must inefficiently devote physical and mental resources to prevent hula hooping.  In a sport where progress is measured by fractions of a second, we can’t afford to miss simple posture cues like this one.  Sometimes we’ll work around the posture and sometimes we’ll actively correct it, but know that a one-size-fits-all approach to stroke instruction and dryland conditioning will not produce optimal results for these swimmers.



-Quad driven kicking - Swimmers are often rewarded for quadricep driven kick patterns in the long axis strokes particularly in sprinting and in intense kick sets.  “Butt kicking” can also be tied to a core imbalance, freestyle flaw: butt kickers.  Given the risk of developing hip imbalances such as tight hip flexors and weak glutes through the anterior dominance of the flutter kick (regardless of whether the kick is effective or ineffective), our dryland preparation should complement these tendencies with a proper focus on the posterior chain.



-Breathing dysfunction - If breathing mechanics are poor, the stability muscles may assume the role of the breathing muscles.  In a faulty breathing pattern (sometimes referred to as paradoxical breathing) the swimmer breathes with chest and low back such that each breath becomes a mini-back extension.  Although this pattern is very subtle, with the number of breaths we take both in and out of the pool, faulty breathing patterns often creep into the stroke through some of the faults discussed above (sway back, arched back).  The stress only increases at higher intensities, particularly in the semi-hypoxic environment in which swimmers live.

Landmines


Many landmines in the low back arise independently of swimming.  However, know that movement patterns become unpredictable even in the presence of low-grade discomfort.  These are typically issues for referral to the medical side, but we all know that highly motivated achievers (which would describe most swimmers) are more than willing to tolerate discomfort rather than seek help.  

Nevertheless, when swimming is the main provocateur of low back issues, don’t forget to look elsewhere for the root cause, such as the thoracic spine and hips.  Create a line of communication with the medical staff beyond “Yes or No” decisions in returning to training.  Getting both the medical staff and the coaching staff on the same page in understanding the swimmers individual stroke tendencies can help accelerate recuperation and prevent injuries.   

-Disc damage - Disc prolapses, herniations, etc. are common throughout society.  The disc can press on lumbar nerves or on the posterior longitudinal ligament which is a highly innervated structure.  
-Nerve damage - Potentially from disc damage, or nerve entrapment from tight muscles.  These symptoms commonly radiate or are described as tingling.
-Stenosis: More typical in the Master’s athlete, but can be perpetuated by tight hip flexors and can cause nerve damage or entrapment.
-Pain - Know that not all damage elicits pain and not all pain results from damage. Pain does not equal injury.
-Fractures - If these occur, there are usually other problems at work such as poor nutrition, but know that inappropriate mechanical stress can break bones under intense repeated use. Many swimmers have low bone mineral density, especially Master’s female swimmers are at risk.  

Assessment   

-Breathing – Friend of the blog Patrick Ward and Carson Boddicker teamed to create this tutorial on how coaches can assess breathing in their athletes.  Watch and you’ll note other problem areas beside the lower back that are implicated by faulty breathing.  Even if you don’t feel comfortable putting your hands on swimmers, you can still gather valuable information by visual observation alone.


-Posture – Learn to identify lower crossed posture. 



Your corrections both in and out of the water will be far more effective if you can identify the lumbar dysfunction as part of a global pattern rather than simply as a tight back.
See also, postural syndrome

-Flexion/extension - As with the thoracic spine, we can check how the lumbar spine functions as part of global movement patterns while standing.  In flexion (forward bending), we look for a slight posterior weight shift with the hips.  In extension, we look for the hips to move slightly forward.   





-Thomas Test – Thigh should drop below parallel to the ground.  Thomas test is also a good exercise for the hip flexors.  If someone fails the Thomas test and has difficulty with the flexion pattern, you are probably looking at a full body postural issue.    


-Pelvic tilting – Can the swimmer actually tilt the pelvis?  We’re not concerned with wide ranges of motion initially.  What counts is whether the swimmer can anterior tilt and posterior tilt on command.  If not, then we need to figure out if the limitation is skill-based or whether there a physical restriction prevents the movement.



- Supine Hip Flexion - With the swimmer lying on their back have them place their hand behind their back and lift their leg until the pressure on their hand changes.  Once the pressure changes, hip flexion stopped and lumbopelvic motion began. This assess inadequate hip flexion active range of motion.

-Push up, planks, marching in plank position – The push up and plank positions requires control of the spine with simultaneous control from the shoulder blades and mobility from the shoulder joint.  Each has different levels of sensitivity for certain nuances, but each is effective to identify the swimmers particularly at risk.

Correction - As with the thoracic spine, there is a vast array of quality exercises for the lumbar spine.  What is more important is your system to assess each swimmer and then determine the appropriateness of each exercise for that swimmer based upon their individual needs.

-Breathing – Train the rib cage to relax and for the breath to come from the diaphragm.  Isolated breathing practice might challenge the attention levels of younger swimmers, but you can integrate breathing training during all exercises.  Breathing is a gauge of whether the swimmer is actually in control of the exercise and isn’t just surviving the move.   

-Soft tissue work – For left vs. right asymmetries, the key areas to hit are the psoas (softball works great) and the quadratus lumborum (also easily addressed with softballs/lacrosse balls/tennis balls).

-Paging the Glute Guy...Glutes protect the lumbar spine and are king of the posterior chain.  Glute training is imperative to get tight back muscles to “calm down” and puts the abs in a better position to function effectively.


-Abs! - 
Tad Sayce offers an informed perspective on training the abdominals and why some traditional approaches can be detrimental to lumbar spine health and performance, NROL - abs for swimmers

-Planks – May be the best bang-for-your buck exercise to train the lumbar spine.  Be a stickler for quality form...level pelvis, engaged lats, firm glutes, neutral head/neck, and proper breathing mechanics.  You can make a simple plank very challenging with attention to detail.  

-Carries - Two of the best lower spinal exercises are also the simplest: Waiter's walks and farmer's carries.  Pick up something heavy, walk, put it down!

Summary

Above all, optimal lumbar function is a matter of control.  Screen and assess your swimmers to determine who has physical deficits in this area.  As with any aspect of training, our goal is to optimize our ability to deliver what swimmers need when they need it.  However, virtually every swimmer can improve their lumbar spine with a stronger posterior chain and properly functioning thoracic spine.  Understanding the patterns of lumbar spine behavior and its relation to nearby body segments is an important step toward technical refinement in the water and effective dryland programming.   

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Tuesday

Trouble Shooting Series: Thoracic Spine


Part two of the trouble shooting series by Allan Phillips see part 1, Troubleshooting Series: Cervical Spine.
 
The thoracic spine (T-spine or mid back) is one of most important yet sometimes neglected regions of the musculoskeletal system. The T-spine connects directly to four major joint systems: glenohumeral (shoulder), scapulae (shoulder blades), lumbar (low back) spine, and cervical spine (neck). Muscles of respiration, trunk extension and flexion, rotation, stroke propulsion, and stabilization are all affected by thoracic spine function. It is the major source of trunk mobility in all planes with a greater inherent range of motion than the lumbar spine.


Virtually every important task in the water flows through the thoracic spine. As such, if the thoracic spine does not function properly, other areas must compensate. Although thoracic limitations can have widespread negative effects in the shoulders, neck, and low back, corrections can have an equally significant positive impact. The shoulders receive most of the attention in swimming, but modern inquiry has led to a greater appreciation of the thoracic spine's role in shoulder safety and performance.

Potholes:  A myriad of stroke flaws can result from thoracic spine limitations.  Whether the limitation is a direct or indirect cause of the flaw will vary on an individual basis, but if someone has an underlying restriction, efficient and safe technique will be more difficult to achieve.  SOMETHING is causing these flaws and it behooves us to explore the possible causes rather than relying on cosmetic solutions alone.      

-Streamlines - Does the streamline resemble a referee signaling a safety, or worse, a field goal?  While this point is not to excuse swimmers who allow streamlines to deteriorate at the end of a long set, there are swimmers for whom a single good streamline is extraordinarily difficult based on their underlying physical characteristics.  Cheating with compensations in the neck or low back is not desirable even if it makes the streamline visually acceptable.


-Backstroke start too flat - A swimmer lacking thoracic extension will have more difficulty bending backward.  This hinders arching, impeding the swimmer's ability to slice through the water to optimize entry.

-Wide arm recovery and Crossing-over – These are separate flaws but both are common compensations by the arms to in response to a thoracic restriction.   If the surrounding muscles are too tight then crossing over or poor distance per stroke can result.

-Hula-hooping: Hula hooping is frequently an indication of a poorly moving thoracic spine.  Insufficient rotation and poor timing are both forms of thoracic spine movement deficits.  If either deficit occurs, the body will seek alternate movement sources, often through excess lateral action.  When the brain says “Go!” the body can only use the resources available to carry out the command.  Even though rotation is more efficient than hula-hooping, the hips will frequently hula-hoop if a thoracic spine has a rotation deficit.   

-Sway back - Sway back often results as part of lower crossed syndrome in which a rounded upper spine is tied to an excessively arched lower spine. Once again, the body going the path of least resistance and if the thoracic spine is too tight.

-Frankenstein upper body in short axis. Poor upper body muscle length and timing can lead to powerful, but graceless movements.  This can increase water resistance and impair swimming velocity.


-Dropped elbows underwater. Keeping the elbow high is the role of the scapular retractors and the ability to internally rotate the shoulder. When surrounding muscles are tight, these muscles can be inhibited (weakened) (pseudoparalysis via Janda, search it if you want more information).

-Lifting head to breathe.  If the T-spine is immobile, the neck may compensate by lifting and possibly side bending in freestyle.
   
Landmines - Injuries are less common in the thoracic spine as compared to its neighbors the cervical spine, lumbar spine, and shoulders.  However, limitations in the thoracic spine are often linked to injuries elsewhere.  Below are several thoracic spine conditions that can develop through improper posture and movement both in the water and on land. 

-Upper crossed posture – A postural syndrome in which certain muscles become overactive and others inhibited.  What may appear as weakness on first glance may be inhibition.  Know that overactive muscles must “calm down” before the inhibited ones can express their full strength. (Is poor posture slowing you down?)

-Fixed kyphosis, go to a pool and see all the swimmers with a hunchback. It is an epidemic! See poor posture

-Disc herniations, this landmine can occur for numerous reasons, but fixed kyphosis may lead to increased pressure in one area of the thoracic spine.

-Soft tissue restrictions (both painful and non-painful), a few well selected tennis ball spots can find sore spots a swimmer never knew about. 

-Shoulder problems - Shoulder injuries are an enormous topic unto themselves and I won’t spend too much time in this post, but know that throacic spine dysfunction puts the shoulder at risk.  Develop a functional T-spine to protect the shoulders!

-Cervical and lumbar problems - If the T-spine ain't doin' its job, the cervical spine and lumbar spine try to pick up the slack in capacities for which they were not designed. 

Assessment - Assessment is a tool to unlock physical limitations in each swimmer’s body.  The purpose of assessment is not only to identify possible sources of stroke flaws and injury predisposition but also rule out possible sources.  Assessing the T-spine also informs us where we can take our athletes with loaded shoulder work.  Trying to find the best lift is often less important than determining whether a certain lift is appropriate for that particular swimmer at that particular time. 

While many swimmers with poor T-spine function are at high risk of injury any time they put a weight overhead, there are many other swimmers with great T-spine function that are wasting their time with unnecessary remedial rotator cuff exercises.  Further, some swimmers have too MUCH mobility. Objective assessment can place swimmers into the right categories.

Below are three of my favorite assessments that are easy to administer in a group setting.       

-Upper quarter rotation.  There are two parts to the upper quarter rotation. In both steps, take a seat and place the toes in a forty-five degree angle, which is easily created by bisecting a ninety degree corner or creating one with athletic tape.    Sit tall, place a rod across the chest, keep the knees stable, and turn to one side.  If the rod passes forty-five degrees, the test is a pass.  Part two is the same as part one but instead we place the bar across the back, which prevents the athlete from “cheating” rotation with the shoulder blades.  Again, forty-five degrees is the benchmark.  For an added challenge, have the swimmer take a deep breath from the belly at their maximum range and observe any changes. 


-Lat length – Athletes may have poor posture but demonstrate more than sufficient T-spine mobility.  In those cases, shortened lats are often a factor behind poor posture, poor distance per stroke, thumb entry during free and/or fly and crossing over.  In the lat length test, lean against a wall with the back and head against the wall.   Keep this position throughout the test…no back arching or neck protrusion.  Lift the arms and try to touch the wall with the thumbs.  Keep the arms straight (no field goals!).  You can also perform this assessment one arm at a time.  As with the upper quarter rotation, cue a deep breath at maximum range to see if they retain full mobility.  There are three possible outcomes on the lat length test.
1)    Touches wall = Optimal
2)    Arm passes nose in profile view = Within normal range but room for improvement
3)    Arm does not pass nose in profile view = Needs improvement


-Pectoralis minor length – A shortened pec minor on one or both sides is often linked to a rounded T-spine.  Whether the shortened muscle causes the posture or whether the posture causes the shortness will vary by individual.  One way to assess pec length is to look at the back of the shoulders while the swimmer is lying down.  From the view in the picture below, the back of the shoulders should rest comfortably on the ground.  If one or both shoulders is protruded upward, the swimmer may have shortened pectorals, which will make quality T-spine movement difficult. 


To assess the pec minor in movement, here is a video that expands on the concept above. 

-General flexion and extension – Coaches can also gain a general sense of flexion and extension ability as part of a global movement pattern.  How the swimmer moves during other dryland activities and even while walking on deck can yield valuable clues about how they control their posture. 

We can also formally assess flexion and extension through the toe touch and backbend. These assessments are not sensitive enough for quantitative analysis, but are extremely valuable to identify those swimmers particularly lacking in these areas.

Toe touch – Have the swimmer stand with feet together.  When we cue the swimmer to touch the toes, one thing to observe is for the upper back to round forward, which is flexion.  Although we don’t want swimmers to live in a flexed posture, we do need to check if they can actively flex that segment of spine to ensure they aren’t locked, which is particularly important during turns.  Note the toe touch can be used for numerous purposes, but for this post we’ll only focus on the upper back.   

Back bend – The corollary to the toe touch is the back bend.  To perform the back bend, have the swimmer stand with feet together and cue them to lean backward.  A spotter should stand behind to ensure no one falls.  The back bend should resemble a backstroke start with a gentle curve from the base of the spine to the top the head.  As with the toe touch, there are many things the back bend can tell us, but for now the main focus is to look for curvature in the upper back.    


Correction
Correction should follow a systematic approach based upon your assessment.   
1.     Soft tissue quality (foam rolling, tennis balls, manual therapy).  Removing tissue restrictions makes our exercises more effective.  Don’t neglect the chest muscles, particularly the pec minor, when performing self massage. (See above)

2.     Corrective exercises.  If you visit this site frequently, you’re sure to notice a steady diet of excellent drills for thoracic mobility.  As such, I won’t repeat them here in this post.  However, if you follow the assessment protocol above or develop your own protocol, you’ll be better positioned to identify which swimmers will benefit from which exercise.

3.     Integration.  We build a foundation of general physical readiness so the body and stroke achieve maximum compatibility.  Once in the water, it’s important to recognize that some swimmers have never swum with an unrestricted thoracic spine.  Certainly with a healthy senior level swimmer we’ll be cautious about making any changes, but forging the link between dryland corrections and stroke improvements can change the career trajectory of a junior swimmer and can be a key to take others off the injury carousel.  When a thoracic restriction is present, it is advisable to first address rotation in long axis and undulation in short axis before making arm corrections.  Arm flaws are often the result of spinal restrictions.  Assignment of drills focusing on the arms should be predicated on the swimmer having sufficient control of their spinal movements.     

4.     Re-check.  Rechecking is critical to ensure the body does not default back to old habits. Changes are not always perceptible while standing on deck.  Racecars go through extensive mechanical evaluation when not on the track…our own racing machines (our bodies) should be no different

Other points on correction….
Never forget non-swimming lifestyle factors as part of a corrective approach: You can have the greatest dryland routine in the world, but if the person goes back to crappy posture at work, school, at home, and in the car, all our efforts go to waste.  Poolside bleachers don’t help matters either!  

To what extent should we correct asymmetries? The upper quarter rotation assessment is a helpful guide to evaluate left to right symmetry.  If a swimmer can’t hit forty-five degrees to either side, correction is usually needed.   Forty-five degrees is a range most general population individuals should have for basic health.  It’s a definite red flag if a swimmer can’t achieve this range.  In fact, some coaches may choose a more demanding standard for their own squads if they deem necessary.    

If a swimmer passes forty-five degrees on both sides but is asymmetrical, evaluate the need for correction on a case-by-case basis.  There are times when underlying asymmetry is best left untouched if it is a critical part of their freestyle.  If a swimmer breathes only to one side (or heavily favors one side), it is important that the underlying left-to-right symmetry reflect this habit.  A more demanding standard of thoracic mobility on a swimmer’s favored breathing side can protect the vulnerable tissues in the shoulder and neck.  Although many swimmers will naturally breathe toward the side with greatest mobility, this does not occur universally.  As such, it is important that coaches gain a full understanding of any limitations or imbalances    

Summary
T-spine limitations both in and out of the water are often the root of symptoms elsewhere in the body.  The shoulders, neck, and core all directly interact with the T-spine.  Additionally, every breath we take (shout out to P. Diddy and Sting) directly affects the T-spine.  As such, any limitations can be magnified when breathing is stressed.  Because the possible stroke flaws and injuries related to the T-spine are well known, a prophylactic approach to assess the T-spine is critical.  As with any assessment, consider overall factors for each individual swimmer.

Guest Post by Allan Phillips. Allan and his wife Katherine are heavily involved in the strength and conditioning community and more about them can be found at pikeathletics.com

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Wednesday

Troubleshooting Series: Cervical Spine

This is a new series by a guest writer Allan Phillips. Allan and his wife Katherine are heavily involved in the strength and conditioning community and more about them can be found at pikeathletics.com

Troubleshooting Series: Cervical Spine

Understanding cause-and-effect lies in the heart of effective movement correction, both in and out of the water. The better grasp we have of the body's movement fundamentals, the more capably we can decipher the visual presentation of stroke flaws. The quotations around “flaws” is intentional, as the flaw that catches our attention on deck may be the body’s default way to compensate for an underlying physical limitation. To achieve lasting results, it is critical to examine the body’s movement fundamentals. Put another way, injury and poor performance are often the result of unchecked dysfunction. While smart training remains paramount, coaches should be heartened that not all injuries are the result of overuse alone. Training exposes movement deficiencies. As such, the greater the training demands, the higher standard of physical preparedness required.

Water Spraying Airsoft paintball Landmine Yellow S-Thunder IGG-201Y
If only every landmine spread paint...

The road to stroke improvement is peppered with both potholes and landmines. We know WHAT the potholes are and we know WHAT the landmines are...less clear is how to identify their location and how to avoid them. Common stroke flaws are like potholes on the road: you can hit a few along the way and still reach your destination safely, but hitting too many will cause damage. The more robust the vehicle (or body), the less disruptive the potholes will be. However, we need not detour around ALL potholes as doing so could add unnecessary time to the trip.

In the pool, there are certainly occasions in which time constraints prevent coaches from avoiding all the potholes. The demands of college scholarships and qualifying standards can limit the coach’s flexibility. Not every coach is in a position to commit to a potentially multiyear process to overhaul every technical flaw. However, such decisions are best made on a case-by-case basis, but not addressing these potholes can lead to injuries. Landmines are injuries and it's no secret what the landmines are in swimming (shoulders, necks, backs...).

Our Troubleshooting series will map these potholes and landmines. Fortunately, the same landmarks that guide us around potholes will also help avoid the landmines and can minimize the damage if we happen to swim through one. Since we know where the problems lie, it behooves us to take a proactive approach to assess each individual swimmer's movement propensities and injury risk factors. Identifying the root of each problem allows us to pick the best tool for job.

Troubleshooting the Stroke and the Body: The Cervical Spine

Why is the neck important?
The cervical spine, or the neck, is a delicate area that protects critical elements of the nervous system. Some refer to the neck as the body’s “circuit breaker.” Neck dysfunction and pain have cascading effects throughout the body and minor insults to this region can have profound implications in swimming. Likewise, the neck is sensitive to other movements in other regions of the body, particularly the thoracic spine (upper back), which sits immediately below the cervical spine. Fortunately, many neck corrections will clean up other aspects of the body's movement, both in and out of the water. Improvements can take both a top-down and bottom-up approach.
Most of what we describe in this post will progress from the top-down by addressing head and neck mechanics before looking at areas further down the body. However, bottom-up approaches with a primary focus on the feet, legs, and hips can also improve the head and neck. Which approach is best will vary by situation, but do note that both approaches are viable.

Common neck related stroke flaws (potholes)

1) Chronically extended neck/excessively high head position - There are several causes of WHY this flaw may appear in all four strokes, including full-body postural syndromes that affect the activation of the neck muscles. However, focusing locally on the neck itself can facilitate improvements elsewhere.
2) Head bobbing – potentially from instability, the neck is like a golf ball on a tee, without proper muscle strength the head will weave throughout the water. This will impede velocity and increase risk for injury, double whammy.
3) Lifting the head to breathe – Neck mobility limitations frequently contribute to this flaw. In freestyle, we know a swimmer with improper breathing biomechanics lifts their head, but what is the root cause? Is it because the swimmer is compensating their rotation deficit with cervical extension? This flaw can cause closure of the interformanial space and lead to various injuries.

Landmines – Are these caused by swimming or does swimming have greater consequences for issues that athletes bring from outside the pool?


It would be misleading to say that swimming “causes” neck injuries in the same way that getting tackled in football causes concussions and fractured bones. Swimming places high repetitive use demands on the neck through flip turns and breathing. Although neither of these tasks are dangerous in themselves, if the neck is not adequately prepared to meet the demands, injuries can result. Plenty of runners have poor neck posture and limited neck mobility, but because running places little stress on the neck we don’t see many neck injuries in running. We must also consider lifestyle factors that predispose swimmers to neck injury such as hours in the car and behind a desk, whether in class or at work. Swimmers who bring physical deficits to the pool are more likely to encounter a landmine.

1) Facet syndrome
2) Fusions
3) TMJ and other jaw related conditions
4) Postural syndromes – Upper crossed and lower crossed posture, or a combination of the two.
5) Any pain, whether or not related to pathology

SCREENING AND ASSESSMENT

One basic question behind assessment and correction for swimmers: "Does the swimmer have a physical limitation that prevents him/her from doing what they need to do in the water?" If no, we can go straight to the in-water correction through drills and stroke cues. If yes, we must take the steps to correct it. However, an objective baseline is helpful to have to observe any changes even when an assessment reveals no limitations.

Swimmers can have similar looking strokes but get there different ways. For example, lifting the head to breathe is a common freestyle flaw. Some swimmers have perfectly functioning necks but lift their head to breathe because they feel like doing so gives them access to more oxygen. Other swimmers lift the head to breathe because the neck lacks rotation ability and they compensate by adding neck extension. The assignment of drills and dryland programming must focus on the needs of each swimmer. While we understand the concern of having to individualize in a large group, proper assessment allows coaches to identify trends within a team and to create appropriate grouping based on collective need.

Some key points to look for in the neck
-Multidirectional mobility – Can the neck flex, extend, and rotate?
-Stability - Can the neck muscles physically support neutral neck posture?
-Overall posture - Faulty neck position can result from postural syndromes involving the whole body (upper crossed and lower crossed along with hybrids of the two)
-Breathing - Training in a semi-chronic hypoxic environment and often breathing poor quality air indoors, swimmers are susceptible to developing ‘tight’ breathing muscles (scalenes, levator scaplae), particularly with the stress placed on respiratory muscles while swimming
-Coordination into global movement – Does the neck function in isolation but lose function when combined with other body movements?
-Medical history - Remnants of old injuries can create lasting limitations. Even if the swimmer doesn’t have pain from the injury, they may have evolved subconscious avoidance habits around the injured site. Additionally, jaw problems are more prevalent than most people realize, especially in young kids. Coaches obviously can’t practice orthodontics, but this information can be useful to understand the swimmer’s tendencies.

CORRECTION

First let’s talk about what NOT to do…
  1. Ballistic neck circles and rolls!
  2. Random static stretching of that neck that has no other justification besides “feeling good.” Tightness can be a protective mechanism and random stretching can turn a mere annoyance into a medical problem. Stretching is appropriate in some cases, but make sure you know what you are stretching and why you are stretching it. This stretching can elongate nerves in the armpit, leading to larger problems.
  3. Heavy weights on the neck machines in the gym
  4. Yoga poses that load the neck, unless under the direction of a capable yoga instructor.

Correction -Dryland

What to do:
-Neck exercises
-Rolling: Neck coordinates with the body roll in a movement that is non-threatening, yet challenging for many people. After all, the long axis strokes are simply an applied form of a partial body roll. Babies and young kids roll with ease, but many people lose this skill as they age.
-Breathing: Watch the athlete breathe. Do they extend the neck to breathe? If you need the neck muscles to obtain oxygen and sustain basic life, can you expect these muscles to be available for use under the crucible of hard training and racing?
-Cueing neutral neck and breathing in ALL exercises – Once you establish a neutral neck at rest, then challenge the athlete’s ability to maintain neutrality under heavier loads. Note, by heavier loads we aren’t necessarily referring to loads upon the neck itself but rather the overall loads of the exercise.
-Posture – Ultimately, correcting the neck may be part of an overall posture improvement (stay tuned for future posts in the context of the thoracic spine, lumbar spine, and hips)

Correction - In water

FINIS Swimmer's Snorkel
Allan loves his pink snorkle!
-Most coaches already have a vast library of drills (remember each drill should be specific and address a swimmer's flaw) and ways to communicate with swimmers. Neck assessment should help refine the choice of what drills are most appropriate based on the underlying dynamics rather than the visual alone. Furthermore, there’s also value in being able to rule out the neck as the culprit.
-Snorkel is an underutilized tool for coaching proper neck position. Many neck problems are the result of excess tension. Masters swimmers and triathletes often have no idea what swimming with neutral neck is like. The snorkel gives them a chance to do so. However, I would exercise discretion in using the snorkel on swimmers with a history of orthodontic treatment and/or jaw pain.
-Create stability with paddles. Paddles are not only used for propulsion. The increased grip that paddles offer with the catch can create better overall stability, which frees the neck to rotate with greater ease (“mobility through stability”).

To Wrap it Up
Limitations in the cervical spine can limit a swimmer’s ultimate potential in the water. Virtually our entire skeleton sits beneath our cervical spine. The slightest change in the neck can have cascading effects throughout the body. In coaching, we need to know what the neck is capable of doing before we ask it to support repetitive advanced movements in the water under physical and mental duress. Dryland screening and assessment gives us a more complete picture of each athlete to help guide the most appropriate coaching strategy. A healthy and properly functioning neck must have the stability to remain neutral yet also freely rotate, flex, and extend when needed. If swimmer’s neck doesn’t possess those abilities, there’s a good chance their stroke has evolved around those limitations. We should not address any aspects of the stroke that affect the neck without addressing the neck itself.

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